Arizona’s Only Health Insurance CO-OP Launches

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Meritus Health Partners, recently licensed by the Arizona Department of Insurance, is Arizona’s first and only health insurance CO-OP (Consumer Operated and Oriented Plan). Established under the Patient Protection and Affordable Care Act, Meritus has launched and will begin offering a variety of health insurance plans on the federally-run online Health Insurance Marketplace and through traditional insurance sales channels beginning Oct. 1.

“We’re a new model for Arizona that will lead the way to better health for our community,” said Meritus Health Partners CEO Kathleen Oestreich. “Our mission as a CO-OP is to improve and maintain every member’s health. A year from now, we want our members to be healthier than when they first enrolled with us.”

The CO-OP will be member-governed, meaning members will make up a majority of its board and will have a voice in how it is run by providing feedback on product design and access to care, among other things—thus continually striving to improve its members’ health.

Meritus, as a health insurance cooperative, is required to reinvest profits back into the organization for the members’ benefit through lower premiums, improved benefits and expanded services—something that sets Meritus apart from other health insurance companies, Oestreich said. “It’s the notion that it takes a joint effort—our members working alongside our staff and healthcare partners—to achieve results that the traditional insurance system has struggled with.”

Meritus will offer 30 benefit plans including Gold, Silver and Bronze HMO and PPO plans initially in Maricopa, Pima, Pinal, Cochise and Santa Cruz counties, and is intended to expand statewide as the provider network continues to grow. To promote its vision for a healthier Arizona, some of the plans include incentives for Arizonans to be—and stay—healthy, including reimbursement for gym membership, alternative therapies and copay-only plans that promote the use of primary care and adherence to chronic care medications.

“The key to achieving a good quality of life is to have access to quality healthcare services that will help people achieve better overall health. Sadly, far too many Arizonans are uninsured, which creates barriers to access healthcare,” said John McDonald, CEO of the Arizona Alliance for Community Health Centers. “But new community-based health plans, like Meritus Health Partners, are going to change the insurance landscape. Meritus is creating new opportunities to access healthcare coverage by removing barriers and making insurance more affordable for all individuals regardless of their income level. I applaud Meritus in its efforts to improve the quality of life for Arizonans.”

According to the U.S. Census Bureau, there are more than 1 million uninsured Arizonans. The ACA requires Americans to have health coverage unless they fall under a specific exemption, including religious beliefs and U.S. citizenship status. Those who aren’t exempt and don’t obtain health coverage will face penalties that will increase each year. Under the new guidelines, no health insurance provider can deny any individual for a pre-existing condition, thereby making it possible for scores of Arizonans to obtain coverage.

Many Arizonans with incomes up to 400 percent of the Federal Poverty Level (FPL) will also qualify for low-cost coverage due to the tax credit subsidies made available through the ACA. Purchasing insurance on the Health Insurance Marketplace (commonly referred to as the Exchange or Marketplace) will allow individuals to use their tax credits, and Meritus Health Partners will have products on the Marketplace that will be eligible for purchase with a tax credit subsidy. Individuals eligible for subsidies must use the online Marketplace to purchase coverage in order to receive assistance. The open enrollment period is from Oct. 1, 2013 through March 31, 2014.

“Because we’re local in Arizona, we know that health care is local and every community’s needs are different,” Oestreich said. “We understand the needs of Arizonans because we live here, too.”

About Meritus Health Partners
Meritus Health Partners is an Arizona member-governed non-profit health insurance model operating as a CO-OP (Consumer Operated and Oriented Plan) established through a loan provision from HHS under the Patient Protection and Affordable Care Act. Meritus has worked with The Centers for Medicare & Medicaid Services for the past year to establish the company as well with the State Department of Insurance for state licensing requirements. The company was created to provide more accessible and affordable health insurance coverage options to individuals, families and small businesses so that we can work together for better health. Our goal is to help people make better choices for their healthcare.

Meritus Health Partners is based in Tempe, Ariz., and is organized as a non-profit.